Turning 65 — What is a Medicare supplemental insurance plan and why do I need one?

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Turning 65 — What is a Medicare supplemental insurance plan and why do I need one?

When turning 65, there are many decisions to make related to Medicare coverage options. Looking to the internet will provide excellent search items, with special attention to Medicare’s publication: “Medicare and Me.”

As decisions are being made, it is important to learn what will heavily impact out-of-pocket expenses — the amounts the patient will be paying.

First: Medicare was never intended to pay for all health care expenses for those 65 and older. Therefore, there will always be an out-of-pocket amount. This patient portion will be impacted by the Medicare plan you choose.

Traditional Medicare: Patient Portions. There will be the every-60 day inpatient deductible. There will be an average of 20 percent for all outpatient hospital services as well as other outpatient services – like oxygen, walkers and rehab. There will be the average 20 percent of allowed charges for each physician visit.

For the Part D/pharmacy package, there will be varying amounts due based on the tier of the drugs you use. Highly important to review the list of drugs you are on and compare against the plan you purchase as Medicare has a patient portion plus the large “do-nut hole” when Medicare pays nothing until you hit the “cap.”

Medicare Advantage/Part C/Managed Medicare/Replacement Plan: They all represent the same thing. We will discuss the out-of-pocket expense for this exception to traditional Medicare shortly. However, there is no ability to have a supplemental insurance plan with Medicare Part C. The patient portion is significantly different than with traditional Medicare.

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